The Dollars & Sense of Telehealth for Community Broadband

“Our remote patient monitoring telehealth program has saved the hospital $2.7 million by reducing chronic care patients’ returning to the hospital or needing to go to the ER,” says Lisa Hogan, RN, head of Chronic Care Management Program for Frederick Memorial Hospital in Maryland.

“Studies of hundreds of our patients six months before and six months after they start this program confirms the financial benefits. We have a few patients as young as 35 year. But many of them seniors with our eldest patient being 100.”

Remote patient monitoring (RPM) is one of the more popular telehealth applications. It can enable seniors to add years to their ability to stay in their homes or possibly moving to a nearby senior facility. This will keep a community’s senior ecosystem active and seniors can still maintain a social and economic role within the community.

From a community broadband owners’ perspective, the app provides an effective incentive to hook potential customers into subscribing to their networks. The owner can offer nice broadband service packages to clinics, physician practices, and hospitals assuming these haven’t signed long-term broadband deals with other ISPs. Seniors aging in place means longer-term broadband customers.

Lisa’s hospital has over 300 custom tablets. She explains that, “There are two different types of monitoring. You can do traditional telehealth with face-to-face video consults between patients and our nurses. And then there’s remote patient monitoring. We install the tablets in patients’ home, store specific questions for their patients regarding congestive heart failure, diabetes or other chronic illnesses, continuously check vital signs, run tests, and call or video conference patients if needed.”

In general, data files coming from each patient transaction may not be significant assuming that these are small data points (temperature, sensor readings, etc.). Nurses checking on patients’ surgical wounds or limbs swelling need sharp video images, which requires transmitting significantly more data. At first you might think, “no one needs a lot of broadband for this small data stream.” But consider these factors.

What if the only broadband Internet access is through slow satellite? Or you have crappy broadband that’s unreliable? Maybe you have adequate speed but awful capacity – family using eight or nine devices simultaneously, 200 neighborhood kids doing video-based homework nightly, Netflix’ blockbuster is more popular than Game of Thrones? Don’t confuse speed – how fast your data goes – with capacity – how many streams of data can fit through your house’s or neighborhood’s wired or wireless connection.

A potential variation of RPM is that community broadband and telehealth can revise the concept of “travel nursing.” The travel nurse is usually supplied as a service by an agency that assigns the nurse on short- term assignments. You can expand this to various travel healthcare positions, including physical and occupational therapy, speech-language pathology, doctors, and dentists.

“The success of a monitoring program, I believe, depends upon the relationship that the nurses build with those patients,”Lisa says. “You have to have consistent nurses taking care of the same patients during during the course the program, so you may have to establish a program to recruit and train nurses for the long-term assignments. You can use regular travel nurses for patients that recently had surgery or some other medical procedures and only need to be monitored for a month or two.”

The town I worked for several years ago had a abandon retail space downtown. While waiting to complete your community network, run 100-meg or a gig line into a similar type of abandon space and run a RPM operation from the building. Run a connection to the nearest physician’s practice or hospital, and set up some fixed wireless routers and customer premise equipment (CPE) to receive data and send data from patients.

Though there are ton of details that must be worked through, a creative community broadband team can set up digital infrastructure for a RPM outpost. The city or county can take responsibility for recruiting, hiring, and training nurses. And the broadband team can share the outpost for recruiting network subscribers.

Learn more from Lori and the rest of our rockin’ telehealth panel at the Broadband Communities conference Thursday, October 31 in Alexandria.

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    Industry analyst, expert broadband business strategist, runs on-site workshops to help clients create effective broadband plans.

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